Missouri judge upholds state lawmakers decision to not fund Medicaid expansion

In same ruling, the judge also said an amendment voters approved to expand the taxpayer-funded health care program is unconstitutional.
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A Missouri judge has upheld  a state General Assembly's decision not to fund Medicaid expansion.

Cole County Circuit Judge Jon Beetem announced the ruling Wednesday in a six-page decision in which he wrote state lawmakers and GOP Gov. Mike Parson acted legally when they didn’t include money for voter-approved Medicaid expansion in the state’s $35 billion budget because the Missouri Constitution prohibits implementation of ballot measures without distinct funding sources.

"This Court concludes that Amendment 2 indirectly requires the appropriation of revenues not created by the initiative and is therefore unconstitutional," Beetem wrote. "Accordingly, this court declines to order the implementation of Medicaid Expansion."

He said under the state’s constitution, a ruling that forces the state to fund the expansion would be a "court-ordered appropriation."

In the same ruling, Beetum also said an amendment voters approved to expand the taxpayer-funded health care program is unconstitutional.

Medicaid expansion proponents vowed to appeal.

“As all observers predicted, the issues around Medicaid expansion will be decided in the Court of Appeals. We are disappointed in today’s ruling, but believe the Court of Appeals will disagree,” attorney Chuck Hatfield and partner Lowell Pearson, who sued the state for “defunding “expansion, said in a statement.

Hatfield abd Pearson said the will immediately appeal this decision to the Court of Appeals for the Western District of Missouri,.

House Speaker Pro Tem John Wiemann, R-O'Fallon, said on Twitter that the ruling is a victory for Missouri taxpayers.

"Pushers of [expansion] erred when they deceived voters by failing to include a funding mechanism," Wiemann wrote. "This unconstitutional initiative would have cost Missourians millions."

Hartfield and Pearson filed the lawsuit May 20 on behalf of three women denied access to Medicaid services they would have been eligible for if expansion went into effect July 1.

Lawmakers approved, and Gov. Mike Parson signed, a $35 billion fiscal 2022 budget without including the expansion. The governor had originally requested a $130 million state match to draw $1.2 billion in federal dollars to provide 275,000 low-income Missouri adults Medicaid coverage.

 –  By John Haughey